1,278 research outputs found
Video assisted thoracic surgery for treatment of pneumothorax and lung resections: systematic review of randomised clinical trials
<b>Objectives</b> To determine if video assisted thoracic surgery is associated with better clinical outcomes than thoracotomy for three common procedures: surgery for pneumothorax, minor resections, and lobectomy.
<b>Design</b> Systematic review of randomised clinical trials.
<b>Data sources</b> Medline, Embase, Cochrane database of systematic reviews, Cochrane controlled trials register. Reference lists of relevant articles and reviews.
<b>Methods</b> Criteria for inclusion were random allocation of patients and no concurrent use of another experimental medication or device. At least two authors performed and confirmed data abstraction and analyses. Information on quality of trials, demographics, frequency of the events, and numbers randomised were collected.
<b>Results</b> 12 trials randomised 670 patients. Video assisted thoracic surgery was associated with shorter length of stay (reduction ranged from 1.0 to 4.2 days) and less pain or use of pain medication than thoracotomy in the five out of seven trials in which the technique was used for pneumothorax or minor lung resection. In the treatment of pneumothorax, video assisted thoracic surgery was associated with substantially fewer recurrences than pleural drainage in two trials (from 20 to 53 events prevented per 100 treated patients). No substantial advantages were observed for video assisted thoracic surgery in lobectomies.
<b>Conclusions</b> Video assisted thoracic surgery is associated with better outcomes and seems to have a complication profile comparable with that of thoracotomy for the treatment of pneumothorax and minor resections. As for lobectomy, further studies are needed to determine how it compares with thoracotomy
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Duurzaamheid, innovatie en risico; vier cases uit de agrarische sector
Belangrijke ingrediënten voor een succesvolle systeeminnovatie zijn 'sense of urgency', ontwikkelingen op verschillende schaalniveaus die bij elkaar aansluiten, congruente belangen van de betrokken actoren, netwerkvorming, bevlogen mensen die de kar trekken en de juiste interventie op het juiste moment. Het vinden van fondsen en het overwinnen van wettelijke barrières en risicoaversie bij ondernemers zijn belangrijke uitdagingen, naast het verwerven of behouden van maatschappelijk draagvlak. De (rijks)overheid speelt een belangrijke rol bij het tot stand komen van systeeminnovaties door subsidieregelingen, experimenteerruimte en het laten uitvoeren van (haalbaarheids)onderzoeken. Beleid kan belemmerend werken door wet- en regelgeving voor milieu- en bouwvergunningen. Een lotingsysteem voor het verkrijgen van subsidies wordt als belemmering ervaren vanwege de onzekerheid. Vangnetten of garantieregelingen om onzekerheid te verminderen en risico's minder ongrijpbaar te maken, zijn belangrijk
Socio-economic impact of microplastics in the 2 Seas, Channel and France Manche Region: an initial risk assessment. MICRO Interreg project IVa
Optimization of 68Ga production at an 18 MeV medical cyclotron with solid targets by means of cross-section measurement of  66Ga, 67Ga and 68Ga.
The future development of personalized nuclear medicine relies on the availability of novel medical radionuclides. In particular, radiometals are attracting considerable interest since they can be used to label both proteins and peptides. Among them, the β+-emitter 68Ga is widely used in nuclear medicine for positron emission tomography (PET). It is used in theranostics as the diagnostic partner of the therapeutic β--emitters 177Lu and 90Y for the treatment of a wide range of diseases, including prostate cancer. Currently, 68Ga is usually obtained via 68Ge/68Ga generators. However, their availability, high price and limited produced radioactivity per elution are a major barrier for a wider use of the 68Ga-based diagnostic radiotracers. A promising solution is the production of 68Ga by means of proton irradiation of enriched 68Zn liquid or solid targets. Along this line, a research program is ongoing at the Bern medical cyclotron, equipped with a solid target station. In this paper, we report on the measurements of 68Ga, 67Ga and 66Ga production cross-sections using natural Zn and enriched 68Zn material, which served as the basis to perform optimized 68Ga production tests with enriched 68Zn solid targets
LOFAR early-time search for coherent radio emission from GRB 180706A
© 2019 The Author(s) Published by Oxford University Press on behalf of the Royal Astronomical Society.The nature of the central engines of gamma-ray bursts (GRBs) and the composition of their relativistic jets are still under debate. If the jets are Poynting flux dominated rather than baryon dominated, a coherent radio flare from magnetic re-connection events might be expected with the prompt gamma-ray emission. There are two competing models for the central engines of GRBs; a black hole or a newly formed milli-second magnetar. If the central engine is a magnetar it is predicted to produce coherent radio emission as persistent or flaring activity. In this paper, we present the deepest limits to date for this emission following LOFAR rapid response observations of GRB 180706A. No emission is detected to a 3 limit of 1.7 mJy beam at 144 MHz in a two-hour LOFAR observation starting 4.5 minutes after the gamma-ray trigger. A forced source extraction at the position of GRB 180706A provides a marginally positive (1 sigma) peak flux density of mJy. The data were time-sliced into different sets of snapshot durations to search for FRB like emission. No short duration emission was detected at the location of the GRB. We compare these results to theoretical models and discuss the implications of a non-detection.Peer reviewedFinal Accepted Versio
Use of TNF-α-antagonists and systemic steroids is associated with attenuated imunogenicity against SARS-CoV-2 in fully vaccinated patients with Inflammatory Bowel Disease
BackgroundPatients with Inflammatory Bowel Disease (IBD) frequently use immunomodulating treatment, which may render them at increased risk of attenuated immunogenicity after vaccination. Immunosuppressive drugs, such as TNF-α-antagonists, have shown an attenuating effect on serological response after SARS-CoV-2 infection. Here we assessed the effects of different types of immunosuppressive medications on the serological response after vaccination against SARS-CoV-2 in patients with IBD.MethodsThis was a prospective observational cohort study in patients with IBD of whom IgG antibody titers were measured after 2–10 weeks after full vaccination against SARS-CoV-2. Patient demographics, clinical characteristics as well as a previous history of SARS-Cov-2 infection, type of vaccine (mRNA or vector), and medication use were recorded at time of sampling. The primary study outcome was the anti-SARS-CoV-2 spike (S) antibody concentrations, measured using chemiluminescence microparticle immunoassay (CMIA) after full vaccination.Results312 IBD patients were included (172 Crohn’s disease [CD] and 140 ulcerative colitis [UC]). Seroconversion (defined as titer of >50 AU/ml) was achieved in 98,3% of patients. Antibody concentrations were significantly lower in patients treated with TNF-α-antagonists vs. non-users of TNF-α-antagonists (geometric mean [95% confidence interval]: 2204 [1655–2935] vs. 5002 [4089–6116] AU/ml, P<0.001). In multivariable models, use of TNF-α-antagonists (percentage decrease -88%, P<0.001), age (>50 years) (-54%, P<0.01) and CD (vs. UC) (-39%, P<0.05) were independently associated with anti-SARS-CoV-2 antibody titers. In patients who received mRNA vaccines, users of systemic steroids demonstrated significantly lower antibody titers compared to patients who were steroid-free (geometric mean [95% CI]: 3410 [2233;5210] vs. 5553 [4686–6580], P<0.05).ConclusionTNF-α-antagonist use is strongly associated with an attenuated serological response after vaccination, independent of the type of vaccination (mRNA/vector), the time interval between vaccination and sampling, prior SARS-CoV-2 infection and patient age. Patients treated with systemic steroids who received mRNA vaccines demonstrated lower anti-SARS-CoV-2 antibody titers compared with patients who were steroid-free at time of serology
Ontwikkeling van een concept voor de bepaling van de gezondheidsstatus van vleeskuikens (onderdeel 1)
In dit rapport worden de resultaten gepresenteerd van de ontwikkeling van een concept voor de bepaling van de gezondheidsstatus van vleeskuikens op bedrijfsniveau. Het doel van het onderzoek was om na te gaan in welke mate de variatie in technische resultaten van koppels dieren wordt beïnvloed door effecten op bedrijfsniveau of de variatie is toe te schrijven aan andere effecten, niet gerelateerd aan effecten op bedrijfsniveau (koppelniveau). Dit onderzoek is uitgevoerd door Wageningen Livestock Research, in het kader van de PPS ‘Breed&Feed4Food’ (AF-14215), medegefinancierd door het Ministerie van LNV (BO-47-001-008) en door de Vereniging Diervoederonderzoek Nederland (VDN). Uit het onderzoek blijkt dat er een belangrijk bedrijfseffect is op de technische resultaten van vleeskuikens. Dit betekent dat er voldoende aanleiding is om voor een concept voor categorisering van de gezondheidsstatus van vleeskuikens uit te gaan van een indeling op bedrijfsniveau
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